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Wednesday, March 25, 2015

How Obesity Became a Disease @ The Atlantic

"The national obsession with weight got a big boost in 1942, when a life-insurance company created a set of tables that became the most widely referenced standard for weight in North America. The Metropolitan Life Insurance Company crunched age, weight, and mortality numbers from nearly 5 million policies in the United States and Canada to create “desirable” height and weight charts. For the first time, people (and their doctors) could compare themselves to a standardized notion of what they “should” weigh.

Weight-loss drugs hit the mainstream in the 1920s, when doctors started prescribing thyroid medications to healthy people.
And compare they did, using increasingly clinical-sounding terms like adipose, overweight, and obese. The new terminology reinforced the idea that only doctors should and could treat weight issues. The word overweight, for example, implies excess; to be overweight suggests you’re over the “right” weight. The word obese, from the Latin obesus, or “having eaten until fat,” handily conveys both a clinical atmosphere and that oh-so-familiar sense of moral judgment.

By the 1950s, even as Hollywood glamorized voluptuous actresses like Marilyn Monroe and Elizabeth Taylor, medicine was taking a different stance. In 1952, Norman Jolliffe, the director of New York’s Bureau of Nutrition, warned doctors at the annual meeting of the American Public Health Association that “a new plague, although an old disease, has arisen to smite us.” He estimated that 25 to 30 percent of the American population at the time was overweight or obese, a number he essentially made up. “No one loves a fat girl except possibly a fat boy, and together they waddle through life with a roly-poly family,” wrote Paul Craig, a physician from Tulsa, Oklahoma, in 1955. Craig was enthusing over a 1907 study that claimed “gratifying results … on the problem of obesity” by putting people on 800-calories-a-day diets and dosing them liberally with amphetamines, phenobarbital, and methylcellulose. (Craig concluded, in a comment that fails to inspire confidence in his methods of scientific inquiry, “Not all people who eat gluttonously grow fat, but no fat man or woman eats, as they claim, like a bird, unless they refer to a turkey buzzard.”)

Jaw wiring quickly fell out of favor, maybe because it stopped working the minute people started eating again.

In 1949, a small group of doctors created the National Obesity Society, the first of many professional associations meant to take obesity treatment from the margins to the mainstream. Through annual conferences like the first International Congress on Obesity, held in Bethesda, Maryland, in 1973, doctors helped propagate the idea that dealing with weight was a job for highly trained experts. “Medical professionals intentionally made a case that fatness was a medical problem, and therefore the people best equipped to intervene and express opinions about it were people with M.D.s,” says Abigail Saguy, a sociologist at the University of California, Los Angeles.

Those medical experts believed that “any level of thinness was healthier than being fat,” writes Nita Mary McKinley, a professor of psychology at the University of Washington, Tacoma. This attitude inspired a number of new treatments for obesity, including stereotactic surgery, also known as psychosurgery, which involved burning lesions into the hypothalamuses of people with “gross obesity.” Jaw wiring was another invasive procedure that gained traction in the 1970s and 1980s. It quickly fell out of favor, maybe because it stopped working the minute people started eating again. (At least one dentist in Brooklyn still promotes it.)"

See the entire article @ The Atlantic